Physicians in private practice have a potentially large role to play in reducing medicine's impact on the environment. The opportunities to reduce your footprint are similar whether you're running a large hospital or a small- to moderate-sized private practice.
There's no right or wrong way to approach this effort. Multiple points of intervention can make a difference, but the emphasis will vary depending on the practice's location, its size, and the urgency of the issues at hand. Practices in areas where water is scarce, for example, might begin by addressing issues of water consumption and waste. In others, the focus might initially be on energy. But in all regions, practices can start to make progress simply by looking at the flow of material coming in the front door and going out the back door.
Instituting a recycling program can go a long way toward reducing the volume of waste. So can converting from disposable to washable patient robes, to e-mail in lieu of paper-based communication, and to printing double-sided documents when a paperless route isn't an option.
Using energy-efficient light bulbs and turning the heat or air conditioner down at night are other simple steps to reduce consumption.
Looking further upstream, consider the impact that your medical and office supply purchasing choices have on the environment. Practices that are able to band together in group purchasing organizations can have an enormous influence. When purchasers express an interest in the environmental impact of their choices, manufacturers listen.
Even if you are not in a group purchasing arrangement, try voicing your concerns to manufacturers. Ask them for more clarity and transparency about what's in the products that you buy so that you can make more informed decisions.
Big changes can occur when consumers let their wishes be known. For example, for years, highly toxic flame retardant chemicals were standard in all types of electronics such as computers. Although such chemicals prevent electronics from bursting into flame, they can also leach into our homes and offices and present a significant problem when it comes time to dispose of these technologies. In response to consumer pressure, several manufacturers have stepped up to phase out particularly toxic flame retardants and to replace them with safer alternatives.
Another hazardous material that's still common in smaller health care settings is mercury. Not too long ago, the health care sector was responsible for as much as 10% of the mercury levels emitted from waste incinerators. But pressure on hospitals and suppliers led to increased use of mercury-free thermometers, sphygmomanometers, and lab chemicals.
Medical supplies can also be shipped in an enormous amount of unnecessary packaging. This can be reduced by making your wishes known to manufacturers, in order to reduce waste coming in the front door.
Depending on the size of your practice, you also may be able to make considerable strides in energy efficiency. In many areas of the country, energy consumers can negotiate with competing suppliers to lock in a contracted price per kilowatt hour for the year. When energy companies compete with each other in a reverse auction to get your contract, prices drop. Consumers can also specify that a certain percentage of the energy come from renewable sources, such as solar, wind, or hydropower.
You can also encourage patients to avoid flushing unused prescription drugs down the toilet. Water treatment facilities are unable to eliminate most of these chemicals from the water system, and trace amounts of pharmaceuticals have been found in streams and rivers across the country.
It is debatable whether these trace amounts are having an impact on human health, but there's no doubt that wildlife is affected and that levels are rising. Some pharmacies and municipalities have started take-back campaigns to safely dispose of unused medications.
Another way to reduce this problem is to avoid prescribing a large amount of a new medication, when a trial week might help determine if the drug is effective and well tolerated.
Don't know where to start? Try visiting the Web site of Health Care Without Harm at http://www.noharm.orgwww.practicegreenhealth.org